Twelve-Month Persistency with Oral 5-Aminosalicylic Acid Therapy for Ulcerative Colitis: Results from a Large Pharmacy Prescriptions Database

Abstract

Overall persistency with oral 5-ASA therapy was low. However, patients receiving once-daily Lialda had significantly higher persistency after 1 year of treatment than patients receiving other oral 5-ASA therapies.

Medication Use Patterns and Predictors of Nonpersistence and Nonadherence with Oral 5-Aminosalicylic Acid Therapy

“…6,7 This finding confirms the problem of medication nonadherence in UC patients in the United States. Oral 5-ASA medication use 21 analyzed a large U.S. pharmacy data file to examine persistency with oral 5-ASA therapy in UC patients. They found that patients receiving once-daily Multi-Matrix System mesalamine had a significantly higher persistence rate after 1 year of treatment than those receiving other oral 5-ASA therapies.…”

“…A gap of 60 days (twice the duration of a monthly prescription) was consistent with a published 5-ASA persistent study. 21 Although patients may need to switch medications due to side effects, lack of treatment efficacy, or other reasons, investigating discontinuation or nonpersistency to index medication provided important information on how patients behaved on their index medications and how long they stayed on the index medication. Restart was defined as the patients who refilled the index medication following discontinuation.…”

“…Few studies have investigated 5-ASA utilization patterns and persistency using administrative claims data that may approximate real-world clinical practice. 15,21 However, the few published studies using claims data analysis have significant flaws in identifying appropriate UC patients (e.g., without using diagnosis codes to confirm UC patients 21 ) and measurement of persistency (e.g., persistency was measured by refill rate at the third and the twelfth month. 15 ).…”

Barriers to Mesalamine Adherence in Patients with Inflammatory Bowel Disease: A Qualitative Analysis

“…As with many chronic diseases, adherence or persistence to maintenance medications is low, reportedly as low as 40% in patients with ulcerative colitis (UC) who are prescribed mesalamine. 1,2 Low adherence has been associated with a higher risk of disease relapse, higher health care costs, and a possible greater risk of colon cancer for patients. [3][4][5] As a consequence, there has been an effort in recent years to identify risk factors for nonadherence in patients with IBD, and to target interventions to these factors.…”

“…16,17 Our understanding of adherence behavior in patients with IBD is thus incomplete, as the methodology of many studies only allows examination of surrogate markers of beliefs or behaviors, such as gender or socioeconomic status, rather than patient-reported barriers to adherence. 2,18,19 Data from other diseases have identified patient-reported barriers to adherence, but these results may not be applicable to the IBD population because of the different demographic distributions of these conditions; the concerns of a woman aged 50 years with breast cancer may not mirror those of a college student aged 20 years with colitis. 20 Qualitative-based research has illustrated that enhancing medication-taking behavior in patients with IBD requires a more in-depth examination of patients' motivations.…”